The ethics codes of the Association of Health Care Journalists and the Society of Professional Journalists call for fair and accurate reporting and editorial independence. But editorial cutbacks, along with pressure on hospitals to market profitable services, may be eroding these standards.

In several recently reported cases, local hospitals have exerted editorial control by supplying pre-packaged stories and other content to news organizations. In some but not all cases, hospitals paid for this special influence. Earlier this year, a Maryland newspaper sold its weekly health page to a local hospital and put the hospital in charge of providing content. The arrangement was halted amid community protest after just one published issue. Broadcast examples include airing of hospital-produced segments with hazy branding or no branding at all, leading viewers to believe the local station reported the story. In some cases, the hospital-created material is even transmitted to a station through an affiliated news network.

Even if disclosed, arrangements in which television or radio stations or newspapers hand over editorial decision-making to hospitals violate the principles of ethical journalism and betray public trust. Content produced by hospitals does not fulfill the duty of news organizations to provide the public with independent medical reporting.

Ethical problems are compounded when media outlets fail to adequately disclose the source of the content, misleading viewers, listeners or readers into thinking it is legitimate news.

News organizations should not run prepackaged stories produced by hospitals unless they are clearly and continuously labeled as advertisements.

News organizations should not favor advertisers or sponsors over competing health-care providers when choosing sources or story topics and should strive to employ a wide variety of sources.

News organizations should develop guidelines for the public disclosure of sponsors and advertisers. These guidelines should prohibit news personnel from appearing in or participating in sponsored programming or advertisements.

The groups said: Our journalistic mission requires us to hold doctors, hospitals, pharmaceutical companies and government agencies accountable to the public. In doing so, we commit to fair and transparent reporting of medical issues.

The Association of Health Care Journalists, based at the Missouri School of Journalism, is an independent, nonprofit membership organization of more than 1,000 health reporters and editors in the United States and 21 other nations. Along with its Center for Excellence in Health Care Journalism, it is dedicated to advancing public understanding of health care issues and improving the quality, accuracy and visibility of health reporting, writing and editing.

The Society of Professional Journalists, based in Indianapolis, is the nation's most broad-based journalism organization, dedicated to encouraging the free practice of journalism and stimulating high standards of ethical behavior. Founded in 1909 as Sigma Delta Chi, SPJ promotes the free flow of information vital to a well-informed citizenry through the daily work of its nearly 10,000 members; works to inspire and educate current and future journalists through professional development; and protects First Amendment guarantees of freedom of speech and press through its advocacy efforts.

The SPJ Code of Ethics calls on journalists to "Distinguish news from advertising and shun hybrids that blur the lines between the two."